Frenkel M
University of Illinois Eye Center, Chicago 60612.
Arch Ophthalmol. 1993 Jan;111(1):50-5. doi: 10.1001/archopht.1993.01090010054026.
The Medicare Resource-Based Relative Value Scale for ophthalmology has significantly reduced the level of reimbursement for surgical fees and only minimally increased evaluation and management fees. Some observers have felt that the methods for determining fees were flawed, and, generally, practitioners have been concerned about a potential loss of income. While reimbursement for individual services is being cut, projections through 1996 indicate that ophthalmology, as a specialty, will receive 55% more funding due to historical trends and increasing ranks of providers. This will translate into a more moderate global reduction in revenue of approximately 11%. The possible implications of the Resource-Based Relative Value Scale include a concentration of ophthalmic surgery into fewer practices, which may be able to distribute medical liability costs over a larger number of procedures. To counter the constraints of fee limits, individual physicians will probably seek to enhance their net income by greater use of paraprofessional personnel, the acquisition of new technologies, and the application of improved management skills.
医疗保险基于资源的眼科相对价值量表显著降低了手术费用的报销水平，而评估和管理费用仅略有增加。一些观察人士认为，确定费用的方法存在缺陷，总体而言，从业者一直担心收入可能减少。虽然单项服务的报销费用在削减，但到1996年的预测表明，由于历史趋势和从业者数量增加，作为一个专科领域的眼科将获得多55%的资金。这将转化为收入更适度的总体减少，约为11%。基于资源的相对价值量表可能产生的影响包括眼科手术集中于更少的医疗机构，这些机构或许能够将医疗责任成本分摊到更多的手术上。为应对费用限制的约束，个体医生可能会寻求通过更多地使用辅助专业人员、购置新技术以及应用改进的管理技能来提高他们的净收入。
